Healthcare Provider Details

I. General information

NPI: 1972499242
Provider Name (Legal Business Name): NOEL MOSKOWITZ
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/14/2025
Last Update Date: 06/14/2025
Certification Date: 06/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2500 GRANT RD
MOUNTAIN VIEW CA
94040-4302
US

IV. Provider business mailing address

2201 EAST ST
TRACY CA
95376-2773
US

V. Phone/Fax

Practice location:
  • Phone: 650-940-7000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WM0705X
TaxonomyMedical-Surgical Registered Nurse
License Number95154133
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: